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General NPI Number Information
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NPI Number | 1205721404
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Entity Type | Individual
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Provider Name | DONOVAN COWANS
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Gender | Male
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 5915 S EMERSON AVE STE 200
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-1972
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Country | US
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Telephone | 317-567-9307
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Fax | 855-915-0244
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Provider Business Mailing Address
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Address Line | PO BOX 718713
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City | CHICAGO
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State | IL
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Zip | 60677-8713
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Country | US
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Telephone | 317-502-3512
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Fax | 855-915-0244
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | RBT-25-441796
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License Number State | IN
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